Neglected Disease Research and Development: The Higher Cost of Lower Funding

Each year since 2007, the G-FINDER project has provided policymakers, donors, researchers and industry with a comprehensive analysis of global investment into research and development of new products to prevent, diagnose, control or cure neglected diseases in low- and middle-income countries. This is the sixteenth annual G-FINDER report, presenting data on investments made in 2022.

Key Takeaways:

• Global funding for neglected disease R&D fell by 10% in 2022, mostly due to increased inflation reducing its buying power. Although less concerning than a policy choice to reduce funding, this still impacts product developers’ ability to plan and conduct R&D. Funders should consider indexing the value of long-term grants to inflation.
• Funding from industry rose to its second highest level ever, including record highs across several diseases. This is good news, but highlights tensions within our definition of ‘neglect’, which requires the absence of commercial incentive. Even if some of this funding is spillover from increasing concern about tropical diseases spreading to high-income countries, we should still aim to lower barriers to market access in LMICs and foster incentives for industry investment, so that even small markets become commercially viable.
• Biologics R&D more than doubled in the three years to 2022, with key funders reducing their funding to vaccine R&D over the same period. Biologics could represent a valuable part of the toolkit for fighting neglected diseases, but have yet to prove they can be distributed at scale in low resource settings. New monoclonal antibodies for RSV could provide proof of concept for using biologics in LMICs.
• The neglected disease pipeline has increased in size by 55% since 2015 and has matured significantly. The share of products in clinical trials rose from 40% to 56% in that period. But with high attrition we may not have enough candidates in the pipeline to meet the product needs across the neglected disease landscape.
• We still lack a good measure for how much funding is ‘enough’, but all indications are that we should be spending more. We can compare neglected disease R&D funding to other sources of global funding, but it’s more informative to look at the actual health impact delivered by new products. The early returns from this investigation point to over a hundred dollars of return on R&D spending for every dollar invested.